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Sperm Readiness Test For Male Fertility

Missouri rates for HCPCS 0255U

Assesses male fertility by examining sperm under a microscope and scoring how many have completed capacitation — the change that makes a sperm able to fertilize an egg. The marker used is ganglioside GM1 on the sperm surface, and the result is reported as a likelihood.

Rates data updated July 2026.

How much does Sperm Readiness Test For Male Fertility cost?

$35.48

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $35.48 for this service. The price depends on where it is billed: about $26.92 from a physician practice, and about $53.70 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$26.92$4.37 to $37.15
FacilityA hospital or hospital-owned outpatient department$53.70$38.02 to $54.95

How much rates vary

Facilitymedian $54 · 10th to 90th $32 to $68Professionalmedian $27 · 10th to 90th $4 to $56
$5$10$20$50$100facility $54professional $27

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$54.95
Typical High
$61.66
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$33.88
Typical High
$109.65
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$21.88
Typical High
$50.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$66.07
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$45.71
Medica
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$77.62
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$34.67
United
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$31.62
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.05
Typical High
$38.02

Where Missouri sits

The same service costs 3.2 times more in South Dakota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Missouri· 11th of 51

$35.48

SD $60.26KY $19.05

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.